title: Contribution and performance of mobile units in an organized mammography screening program.
abstract: BACKGROUND
  The aims of this study were to evaluate the contribution of mobile mammography units to participation rate and to compare their performance to fixed screening centres within the organized mammography screening program of Quebec, Canada.
  
  
  METHODS
  The study is based on all screening mammograms carried out in women aged 50-69 who participated in the Québec program from 2002 to 2010. Performance was measured by screening sensitivity, false-positive rate (1-specificity), positive likelihood ratio as well as abnormal call rate, detection rate, interval cancer rate, positive predictive value, and tumour characteristics. Poisson regression models with robust variance estimation were used to take into account the multi-level structure of the data. All models were adjusted for characteristics related to women.
  
  
  RESULTS
  During the 2002-2010 period, 2,292,592 screening mammograms were performed, of which 42,279 (1.8%) were in mobile units. In regions serviced exclusively by mobile units, the participation rate reached an average of 63.4% during the 2006-2010 period compared to 54.7% for the entire study population. Estimated sensitivity was similar to that of fixed sites (rate ratio = 0.98 [0.84-1.15]) while the false-positive rate was lower (rate ratio = 0.76 [0.57-1.02]) although this difference was of marginal statistical significance (p=0.07).
  
  
  CONCLUSIONS
  In this program, mobile mammography units allowed regions lacking a fixed centre to attain participation rates slightly higher than those in the rest of Quebec, without loss of sensitivity and with some gain in the false-positive rate.
authors.affiliation: Direction de l’analyse et de l’évaluation des systèmes de soins et services, Institut national de santé publique du Québec, Québec, QC, Canada.
authors.forename: Anne-Maëlle
authors.initials: AM
authors.lastname: Fontenoy
authors.forename: André
authors.initials: A
authors.lastname: Langlois
authors.forename: Sue-Ling
authors.initials: SL
authors.lastname: Chang
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Daigle
authors.forename: Éric
authors.initials: É
authors.lastname: Pelletier
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Guertin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Théberge
authors.forename: Jacques
authors.initials: J
authors.lastname: Brisson
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008952:Mobile Health Units; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D011792:Quebec; D012680:Sensitivity and Specificity
keywords: Breast neoplasms; mammography; mass screening; mobile health units; mobile mammography